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. 2018 Apr 16;10(4):74-82.
doi: 10.4253/wjge.v10.i4.74.

Impact of the timing of capsule endoscopy in overt obscure gastrointestinal bleeding on yield and rebleeding rate - is sooner than 14 d advisable?

Catarina Gomes  1 , Rolando Pinho  2 , Adélia Rodrigues  2 , Ana Ponte  2 , Joana Silva  2 , Jaime Pereira Rodrigues  2 , Mafalda Sousa  2 , João Carlos Silva  2 , João Carvalho  2
Affiliations

Impact of the timing of capsule endoscopy in overt obscure gastrointestinal bleeding on yield and rebleeding rate - is sooner than 14 d advisable?

Catarina Gomes et al. World J Gastrointest Endosc. .

Abstract

Aim: To evaluate the impact of the timing of capsule endoscopy (CE) in overt-obscure gastrointestinal bleeding (OGIB).

Methods: Retrospective, single-center study, including patients submitted to CE in the setting of overt-OGIB between January 2005 and August 2017. Patients were divided into 3 groups according to the timing of CE (≤ 48 h; 48 h-14 d; ≥ 14 d). The diagnostic and therapeutic yield (DY and TY), the rebleeding rate and the time to rebleed were calculated and compared between groups. The outcomes of patients in whom CE was performed before (≤ 48 h) and after 48 h (> 48 h), and before (< 14 d) and after 14 d (≥ 14 d), were also compared.

Results: One hundred and fifteen patients underwent CE for overt-OGIB. The DY was 80%, TY-46.1% and rebleeding rate - 32.2%. At 1 year 17.8% of the patients had rebled. 33.9% of the patients performed CE in the first 48 h, 30.4% between 48h-14d and 35.7% after 14 d. The DY was similar between the 3 groups (P = 0.37). In the ≤ 48 h group, the TY was the highest (66.7% vs 40% vs 31.7%, P = 0.005) and the rebleeding rate was the lowest (15.4% vs 34.3% vs 46.3% P = 0.007). The time to rebleed was longer in the ≤ 48 h group when compared to the > 48 h groups (P = 0.03).

Conclusion: Performing CE within 48 h from overt-OGIB is associated to a higher TY and a lower rebleeding rate and longer time to rebleed.

Keywords: Capsule endoscopy; Diagnosis; Overt-obscure gastrointestinal bleeding; Rebleeding; Therapeutic; Timing.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflict of interest for this article.

Figures

Figure 1
Figure 1
Kaplan–Meier curve in all patients, analyze the % of patients that had rebleed along the time.
Figure 2
Figure 2
Kaplan–Meier curves according to the time of capsule endoscopy performance after overt-OGIB. A: The rebleeding risk in the ≤ 48 h group was 11.8% and 18.5% at 1 and 3 yr, in the 48 h-14 d group was 20.1% and 37% at 1 and 3 yr, and in the ≥ 14 d group was 21.9% and 46.9% at 1 and 3 years. The rebleeding risk was not significantly different between groups (P = 0.055); B: The rebleeding risk in the ≤ 48 h groups was 11.8% and 18.5% at 1 and 3 yr, compared with 20.1% and 37% at 1 and 3 yr in the 48 h-14 d group (P = 0.151); C: The rebleeding risk in the ≤ 48 h groups was 11.8% and 18.5% at 1 and 3 yr, compared with 21% and 42.6% at 1 and 3 yr in the > 48 h group. The rebleeding risk was significantly different between groups (P = 0.03); D: The rebleeding risk in the ≤ 48 h group was 15.6% and 26.8% at 1 and 3 yr, compared with 21.9% and 46.9% at 1 and 3 yr in the ≥ 14 d group. The rebleeding risk was significantly different between groups (P = 0.047).
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